RECElVEDNo... ... .. ... .... .. ......... ... Somerset RegionalCouncil

RF£EIVED

dn W 2019 28 MAY 2019

)A Form 1 -De4 elopmentapplication details oacio

gggqyed form (version 1.1 effective 22 JUNE 2018) made undersection 282 of the Planngy ¿v iù.This form must be used to make a developmentapplication involving code assessmentor impact assessment,except when applying for development involving building work.For a developmentapplication involving buildingwork only, use DA Form 2 - Building work details.For a developmentapplication involving buildingwork associated with any other type of assessable developrnent(i.e. materialchange of use, operational work or reconfiguringa lot), use this form (DA Form 1)and parts 4 to 6 ofDA Form 2

- Building work details.Unless stated otherwise, all parts of this form must be completed in full and all required supporting informationmustaccompany the development application.One or more additional pages may be attachedas a scheduleto this development application if there is insufficientspace on the form to includeall the necessary information.

This form and any other form relevant to the development application must be used to make a developmentapplication relating to strategic port land and Brisbane core port land under the Transport infrastructureAct 1994,and airport land under the AirportAssets (Restructuring and Disposal)Act 2008. For the purpose of assessing adevelopmentapplication relating to strategic port land and Brisbanecore port land, any reference to a planningscheme is taken to mean a land use plan for the strategicport land, Brisbaneport land use plan for Brisbanecoreport land, or a land use plan for airport land.

Note: All terms used in this formhave the meaning given under the PlanningAct 2016, the Planning Regulation2017, or the DevelopmentAssessrnentRules (DARules).

PART 1 - APPLICANTDETAILSApplicarit name(s) (individÚalorcoÈrMnÿfullna n R,R IQ t TO #79 D U../J (V t N/..:rContact name (only applicable for companies)

Postal address (P O. Box o street a dress) . ( ~l $lSuburb (4 i L COState

. (9. c....I)Postcode 549'ISCountry p /k Q$T /%.ABContactnumber

. . 04- -É>ÙÒOEmail address (non-mandatory) Ü wry inclyo·ft | < ? OD? O ?fDLMobile number (non-mandatoryFax number(non-mandatory):Applicant's reference nurnber(s).(itaplicable) .

.2.1)is written consentof the ownår quirÊdfor th. d velo rife pplisÑiönf. . . ...

@Yes the written öonsent.äfthe. wneï(s i an I eÊt t deUël me itiáp lidati0n e.:No proce 3) .

P NTEREDDATE: 'l 1 INITIALS

QueenslandGovemment

PART 2-

LOCATION DETAILS

°Street address'ANDlot on,planjatt lots inustbe listäd);.orO Street addressAND lót on plÃrifor an adjoinihgor j cent proper y of the premises (appropriatefordevelopmentinwaterbut adjoining or adjacent.tölandë.g. jetty, pontoon;all lots must.be listed). . '

Unit No. . Street Nó. Stre t Narne and Type ...Suburb

a)Postcode Lot.ljlo. I länyÿbeaNdNufnbére .;RF F LðcálGovernment Area(s)

5.l·3 lÚll+ GOMC¯l?£?¯T'Unit No. StrèetÑ . . S eét När é.a ?y e . . . Suburb .

b)Postcode l'ot No PláríType aódNuinber (e. . RP P) Local GövernrnentArea(s)

N Al - $OVn £5¯l2SET'

O Coordinatesof premises by longitude anil latitùd.eLongitude(s) Latitude(s) Datum Local GovemmentArea(s) (if appiloable)

2f3'5l"5 wf29 7"5 50m -T°Other

O Coordinatesof premises by.èasting arid northirigEasting(s) Northing(s)

.Zonë Ref3 D.atuin

. . .Loöäl GovérnmentArea(s) (ifapplicable)5 WGSN

5.. O GDA94

G56 O Othèh

O Additional premises are relevant o tiis dé I rrienlapÒliòäiloand theirlietails have beén attached in aschedule to this application .

2 Not required

O in or adjacent to a water body or watercourse or in or above an aquiferName of water body, watercourseor aquiferO On strategic port land under the Transport InfrastructureAct 1994Lot on plan descnptionof strategic port land

Name of portauthonty for the lot

O in a tidal area .Name of local government for.the tidal ai·ea (ir.applicable)Name of port authority for tidal area (iapplicable) .O On airport land under the AirportAssets (Restructurig at d Disposel)Act 2008_Name of airport: . . . . . .. . . .._....- ,

- -·

Page-2DA Form 1 - DevelopmentApplicationdetailsVersion 1.1-22 JUNE 2018

Listed on the EnvironmentalManagement Register (EMR) under the EnvironmentalProtectionAct 1994EMR site identification

O Listed on the Contaminated Land Register (CLR)under the EnvironmentalProtectionAct 1994CLR site identification

5) Are there any existing easements over the premises?Note: Eåsementuses vary throughoutQueenslandand are to be identifiedcorrectlyand accurately.For furtherinformationon easementsand ,

ow they may affect the proposeddevelopthent,see DA Forms Guide.

Yes - Ail.easëmeÁtlocatiònsktypáändsmensionsas includedin)(an(sul¼iúeäälitl¼thÏsde?el pmeÀ. applicätion . &No

PART 3- DEVELOPMENT

DETAILS

Section 1-

Aspects of develooment

a) What is the type of development? (tick only one box)

°Matenal change of use BReconfigunng a lot O Operational work °Buriding workb) What is the approval type? (tiekonly one boxDevelopmentpermit D Prehminaryapproval O Preliminaryapproval that includes

a variation approval

c) What is the level of assessment?Code assessment D Impactassessment (requaespubhc nokfication)

d) Provide a bnef desenption of the proposal (e g 6 unit apartmentbuildingdefinedas multi unit dweihng, reconfigurationof 1tot mto 3

L tà R P Is3/4 and l- 44UK¯3/d415emaf }?sf ær.r.45 Pux/30Ses M?fhemtt 4 L m?isair pd W i s-àne) Relevan)plans . .

Note:Relevantplans are requiredto be sÄmittedforall aspectäof this developmentapplication.Éorfurtfierinfärmation,¯seeDÄ Forms aulde: ?Relevant plans.

Relevantplans of the.ñtoposeddéveloptbent e"altacNeÊtoÙedeÈlopMèbtäpplication

a) What is the type of development? (tick only one box)Matenal change of use Ò Reconfigunng a lot °Operationalwork O Building workb) What is the approval type? (tackonlyonebox)Developmentpermit O Prehminary approval O Prehminaryapproval that includes a ilanation

approval

c) What is the level of assessment?Code assessment Q Impactassessment(requiespubhcnoklication)

à) Provide a bnef descnption of the proposal (ey e unit apartmentbwidmgaermed as mulk-urntdweihng reconfigurationof 1 tot into 3

for aa.ess purpo3es over I-¼ 3 ! '4dor b?n?fN Bf I- % Ñ?!ST3i4 Gd145~ W /e) Relevant plans

Note: Relevantplansare requiredto be sub?nitteÀforil aspects N thisÜevÜopÑÀnt.äp&?t i the ini i tion, see DA Forms Guide:Rele¯vantplajis.lielevantplans of the proposed.develoörnentare attacSdto:tbedevelopment áþplication

Page 3DA Form 1 --. DeveiopmentAppiication detajis

Versionli1-22 JUNE 2018

°Additionalaspects of develo rÀentaré relevanttö this dè?elopmentäppliöafionand the ietaßsfor these aspectsthat would be required undeñPärt 3 Sectiöntof thisfojm.h e been attached tò this dev ilopmentapplicatioriSection 2 -

Further develo ament details

Måtérialchange f use . .DYës coinnlétedivÍsion1 f assessab e agäinst a local planning instrùment

Recönfiguring a lot . Yes coi?ipletèdivisjon2Operationalwörk . . °Yes mpiete divisíof(3 .. . . .Building work . Ye coinp éte D l¯ol'ni 2 ßuilding work details

Division 1 - Material changeof useNote: This division is only requiredto be completed fany part of the developmentapplication involves a materialchange of use assessableagainst alocal olanning instrument.

Provide"á generáljiescripiiri of thé Providétheplarining.scliernedefinition Nurnber'ofdwelling Gross floorproposed use (includeeacïùseririitioninäneWròw) uniïsÄfapplicable). area (m2)

(ifapplicable)

N|A

°Yes°NoDivision 2 - Reconfiguring a lotNote: This division is only required to be completed if any part of the develoomentavolication involves ?configuringa lot.

Subdivision (complete 10)) °Diiriding lánd irïtoþartsby ágreement (corètete11))B¼ündaryrealignmelit(com / 12)) . . Creajiriförchänöingèneasement giving access to a lotròm a constructionroäd (compleie1?))

Intended use of lots cïeated Rësidenti ? Commercial ndustrial Other, please specify:

Numberof lots created

°Yeä-: provideadd t ona deta à be o . . . . . ?How many stages wi I the works include? .What stage(s) will this deýelopment applicationapply to? .

Page4DA Form 1 - DevelopmentApplicationdetailsVersion 1.1...--.22 JUNE 2018

) Dividing land into parts by agreement- how many parts are b ing created and what is th,e intended use of theparts? .Intended use of parts created Residential Commercial Industnal Other, please specify

Numberof parts created

Ôíifi ht t N : : onosedot#:7. 2 . .c_Lot on plan

desc i tion a 2 . , O d ri tion , Ärea (rn2

Existing or . . dth m) èr th i ) s th a erNêÑt nt(ffjb iaNd/loys)proposed? . edestrian.apss) . èënefitted by the easement .

%Pue O 205° felmr faz éram ßv L44%dP/531(WYa Of(1/W fntNH)(372£GT E¯6rioNNI- douNcaL_

LJ Yes- a copy of the decision notice is attachedto this developmentapplicationO Local govemment is taken to have agreed to the superseded planning scheme reque'st- relevant documentsattachedNo

Page 5DA Form 1 - DevelopmentApplicationdetails

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PART 5 - REFERRAL DETAILS

No, there are no referral requirementsrelevant to any development aspects identified in this developmentapphcation - proceed to Part6Matters requrnng referral to the Chief Executive of the Planning Regulation2017:O Cleanng native vegetation

Contaminated land (unexplodedordnance)

° Enyironmentally relevant activities (ERA) (onlyafthe ERA have not been devolvedto a local government)Fishenes- aquaculture° Fishenes- declared fish habitat areaFishenes - manne plantsFishenes- waterwaybarner worksHazardous chemicalfacilitiesQueensland bentage place (onorneara Queenslandhentage place)Infrastructure- designated premrses° Infrastructure- state transport infrastructureInfrastructure- state transportcomdorsand future state transportcomdorsinfrastructure- state-controlledtransport tunnels and future state-controlledtransporttunnels° Infrastructure- near a state-controlledroad Intersection°On Bnsbane core port land near a State transport comdoror future State transport corndorO On Bnsbanecore port land - ERA°On Bnsbane core port land - tidal works or work in a coastal management distnctO On Bnsbane core port land - hazardous chemical facihty°On Bnsbanecore port land- taking or interfenng with water°On Bnsbane core port land - referable dams°On Bnsbane core port land - fishenesO Land within Port of Bnsbane'spart hmits

O SEQ developmentareaO SEQ regional landscape and rural production area or SEQ rural kving area- tounst activity or sport andrecreation activrty°SEQ regional landscapeand rural production area or SEQ rural kving area - community activity°SEQ regional landscape and rural production area or SEQ rural hving area- indoor recreation°SEQ regional landscape and rural productionarea or SEQ rural kving area - urban activity°SEQ regional landscape and rural production area or SEQ rural kving area - combined use°Tidal works or works in a coastal management distnct°Reconfigunng a lot in a coastalmanagement disinctor for a canalErosion prone area in a coastal management districtO Urban design

°Water-relateddevelopment - taking or interfenng with water°Water-related development - removingquarry matenal (from a wate course orlake)°Water-relateddevelopment- referable dams°Water-relateddevelopment- construction of new levees or modificatronof existing levees (categorys ieveesonly)°Wetland protection areaMatters requinng referral to the local government:°Airport land°Enyrronmentallyrelevant activities (ERA) (onlyafthe ERA have beendevolvedto localgovernment)O Local hentage places

Page6DA Form 1 -- Development Appiicationdetalis

Version 1.1- 22 JUNE 2018

Matters requiring referral to the chief executiveof the distributionentityor transmission entity:Electncity infrastructure

Matters requinng referral to? The Chiefexecutiveof the holderof the licence, if not an individual? The holderof the licence, if the holder of the kcence is an individual

°Oil and gas infrastructureMatters requinng referral to the Brisbane City Council:O Brisbanecore port land

. Matters requtnng referral to the Ministerunder the TransportinfrastructureAct 1994:O Bnsbane core port land (inconsistentwith Bnsbaneport LUP for transport reasons)O Strategicport landMatters requinng referral to the relevantport operator:

°Land within Port of Bnsbane's port limits (below high-watermark)Matters requinng referral to the Chief Executiveof the relevant port authority:°Land within limits of anotherport (belowhigh-watermark)Matters requinng referral to the Gold,Coast Waterways Authority:O Tidal works, or work in a coastal managementdistr et in Gold Coast watersMatters requinrig referral to the Queensland Fire and Emergency Service:

0 T idal works manna (more than six vesselberths)

O Yes - referral response(s)received and hsted below are attached to this developmentapphcation@ NoReferral requirement Referralagency Date of referral response

Identif and des¼ribe.any.changésmäde lo the brþposeddevölpfimenta li tion that asihe ubject of the .referral.response and.the devélöpment appljcatiorrthe subject!ofthis fomí; or include details in a schedule to thisdeyebpm¼ntapplicãtiön(i$plÁable . . .. . . . . . . . .. =. . . . . .

PART 6 - INFORMATIONREQUEST

$ I agree to receive an informationrequest if determinednecessaryfor this developmentapphcationD I do not agree to acceptan information reqùest for this development apphcationNote By not agreeing to accept an informahonrequest I the apphcant, acknoviledge? that this developmentapphcahon will be assessed anddecidedbased on the informahonpmvidedwhen making this developmentapphcahon

and the assessment manager and any referral agencies relevant to the developmentapphcahonare not obhgatedunder the DA Rules toacceptany addihonalinformahonprovidedby the applicantfor the developmentapphcation unless agmed to by the relevantparkes

? Part3 of the DA Rules willshilapply if the apphcahonis an apphcahon hstedundersection 11 3 of the DA RulesFurtheradvice obout informationrequests is contained in the DA Forms Guide

Page 7DA Form 1 - DevelopmentApplicationdetails

.. .. .. - .- _. .. -- _ .... . _ ~ ~ :-- _..·

..

Versjo_nQ- 22 JUNE 20

PART 7 - FURTHER DETAILS

°Yes - providedetails bèlow or includédetails inta s heduléto this developmentapplicationNoList of approval/development . . Referencenumbe ..··

Dàte. .

·. Assessment

application referènces · . . . .. . .·

. .. manager

Approval .Developmènjapplicatiön

O Approÿal

°Developmentapplicatiön

O Yes - a copy of the receintedQLeave fofm is attached to this develòpinentapplication

°Now I, the applicant.will provide evidence.that.the portablelong service leave leûy has·been paid before thëassessment rnanagerdecides the devëlóprnen{applicatioriTacknoùlledgeth'at the assessrnentmanager may givea developmentapprovalonly if I provideevidence that the pörtable long servióe leave levy has.beén paid

"

Not applicablë (e.g. building and coästructioùwork iWess than $150,000 ekcliading·GST)

Amount paid Date þaid(dd/mm7?ý).: . .. Öl..eavelèíly number

22.)Is this developrnent.application in résponsertö a show cause notice or required as a result of an enforcement¼hòtige? ? ., -+,O Yes - show cause or enforcementnotice is attachedNo

E] Yesi the requiredattächrnent(förm ESR/2015/17.Ö1)'fobn application fór an eñv.ironmentalauthorityaccompaniesthis development application:·and details are provided ir! the table belowNo

Note:Applicationfor an environmentalauthoritycan be foundby searching"ESR/2015/1791"as'a search term at www.'qid.aov.au. An ERA

requiresen environmentalauthority to operate..Seewww.businessqld.qov.aufor furthefinformation..

Proposed ERA number: PropossdERA threshöld:

Proposed ERA name:· Multiple ERAs are applicable to this developmént applicationand the details have been attached in a

sçhedule to this development.application. ..· : . .

Yes - Form 69: Notification of a f cilityëxçeedind10°oofsähedulè 16threshold is attabbed tö this development

application ·· . .No .

. . .

Note: See www.business.ald.aov.aufor furtherinfortriationabouthazadous chemicalnotificätions. ·

Page 8DA Form 1 -- DevelopmentApplication details

Version 1.1- 22 JUNE 2018

O Yes - this development application includes wntten confirmationfrom the chief executive of the VegetationManagementAct 1999 (s22Adetermination)@ NoNote 1 Wherea dovolopmentapphcation for operationalwork or matenalchange of use requires a s22A determinationand this is not included,the developinentapphcahonis prohibited development ~?2 See httos /Avww old gov au/environment/landtveaetabon/anplymqforfurther infortnakonon how to obtain a s22A determinekon

O Yes -I acknowledge that an environmentaloffset must be provided for any presenbed activity assessed as

having a sigrnficantresidual impacton a prescnbedenvironmentalmatterNo

Note. The environmental offset secleonof.the Queensland.Go ernment'swebsite.canbe:accessed.gwww.ald.aov.au.for,furtherinformation onenvironmentätoliset

YesNo

Note See guidancematenalsat www des oldgov au for further infonnakon

Yes - the relevant template is completed and attached to this development application andI acknowledge that a

relevantauthonsationor licence under the Water Act 2000 may be required pnor to commencingdevelopmentNo

Note Contactthe DepartmentofNaturalResources. Mines andEnergyat www dntme qld aov au forfurtherinformakonDA templates are available from htlos //olanning dsdminaid gov auf if the developmentapphcahon involves? Takingor interfenngwith undergroundwater through an artestanor subartesianbore complete DA Form 1 Template 1? Takingorinterfenngwith watorina watercourse lake or spnng complete DA Form1 Template2? Taking overlandflow water complete DA Form 1 Template3

Yes - the relevanttemplate is completedand attached to this developmentapplication2 NoDA templates are availablefrom https //nlanning dsdmipafd aov au/ Fora developmentapphcation involvingwaterway bemer works, completeDA Form 1 Template4

Yes - an associated resourceallocationauthonty is attachedto this development apphcation, if required underthe FisheilesAct 19948 NoNote See guidance matenals at wwwdafaid gov au for furthor information

Page9DA Form 1 - DevelopmentApplicationdetailsVersion1.1-22 JUNE 2018

Yes -I acknowledgethat efluarry matérialalÍocätionnotice must be!o¼tainedisriorto commencingdevelopment

NoNote: Contactthe Departmentof Natural Resources|Mines and Energyativww.dn'rme'aid.aov.auand www.business.ald.aov.aufor furtherinformation.

O Yes -I acknowledge that a quèrry material allocatiòn noticë must be obtairiedprior to cornmencingdevelopment

S No .... . . .Note: Contactthe Departmentof EnvironmentandScienceat whiw.des.ald.qov.aufor furtherinforrnation.

O Yes - the 'NoticeAccepting aËailureIrnpact Assessment' from the chief executiveadministeringthe Water

Supply Act is attachedto this developmentäpplication

Note: See guidance'materials at www.dncme.ald.cov.aufor fu'rtherinformation..

O Yes - the following is includedwith this deitelòpmentapplica ori:O Eviddhce the proposal meets.thecode for assessable developmentithat.is prescribedtidal work (onlyrequiredif application invöives prescribedtidal work)

DA certjficátä.of titleNo

Note: See guidance materialsat www.des.ald.aov.aufor further infoïmation.

O Yes - details of the heritage place are.provided in the table bèlowS No . .Note: See guidancematerialsat www.des.ald.aov.aufor infoi-mation¯requirementsregardingdevelopmentof Queenslandheritageplaces.

Name of the heritage place: Place (D: .

O Yes - this developmentappfication demonstrateshow the proposal meets the code for a developmentapplicationfor a brothel under Schedule3 of the Prostitution Regulation 2014 . --No

. . . . . . . . . .

O Yes - this application will be take o be an ap I cation.for.a decisiòn undersection 62 of the TranspoftInfrastructurehot 1994 (s ect to the còriditìò s n séction 75 of.the TränsportlnfrastructureAct 1994 beingsatisfied)

No . .

Page 10DA Form 1 - DevelopmentApplication detailsVersion 1 1.-- 22 JUNE 2018

PART 8- CHECKLISTAND APPLICANT DECLARATION

I have identified the assessment manager in question 15 and all relevant referralrequirement(s) in question 17 @ YesNote See the Planning Regulation2017 for referral requirementsIf building work is assocrated with the proposeddevelopment, Parts 4 to 6 of DA Form 2 - § YesBuilding work details have been completed and attached to this development application O Not applicableSupporting informationaddressing any applicable assessmentbenchmarks is withdevelopmentapplicationNote This is a mandatoryrequirementand includes any relevant templatesunderquestion 23, a planningreport Yesand any technicalreports requiredby the relevantcategonsinginstruments(e g local govemmentplanningschemes, State PlanningPolicy, State DevelopmentAssessmentProvisions) For further information,see DAForms Guide PlanninaReport Temofate

Relevantplans of the developmentare attached to this development applicationNote Relevant plans are required to be submitted for all aspects ofthis developmentapplication For further esinformation,see DA Forms Guide Relovantplans

The portable long service leave levy for QLeave has been pard, or will be paid before a O Yesdevelopmentpermit is issued (see 21)) @ Not applicable

@ By making this development apphcation, I deciarethat all information in this development apphcation is true andcorrect© Where an email address is provided in Part 1 of this form, I consent to receive future electroniccommunicationsfrom the assessmentmanager and any referral agency for the developmentappkcationwhere written information isrequired or permittedpursuantto sections 11 and 12 of the Electronic TransactionsAct 2001Note It is unlawfulto intentionallyprovide false ormisleadingsniormationPrivacy- Personal informationcollected in this form will be used by the assessmentmanagerand/or chosenassessmentmanager, any relevant referral agency and/orbuilding certifier (includingany professional adviserswhich may be engaged by those entitles) while processing, assessingand deciding the development apphcationAll information relating to this development application may be available for inspection and purchase, and/orpubbshedon the assessmentmanager's and/or referral agency'swebsitePersonal information will not be disclosed for a purpose unrelated to the PlanningAct 2016, Planning Regulation 2017and the DA Rules except where? such disclosure is in accordance with the provisionsabout pubhc access to documentscontained in the Planning

Act 2016 and the Planning Regulation2017, and the access rules made under the PlanningAct 2016 and PlanningRegulation 2017, or

? required by other legislation (including the Right to /nformationAct 2009), or,? otherwise requiredby lawThis Information may be stored in relevantdatabases The informationcollected will be retainedas required by thePublicRecords Act 2002

PART 9 - FOR OFFICE USE ONLYDate received: Referencenumber(s):

Prescnbed assessmentmanagerName of chosen assessmentmanagerDate chosen assessment manager engagedContact numberof chosen assessmentmanager

Page 11DA Form 1 - DevelopmentApplicationdetailsVersion 1.1·-- 22 JUNE 2018

Relevant icërìce number(s)of chósen aséessmentmanager . . .. ";. .... :... .. . .

Descnptionof the workQLeave project numberAmountpaid ($)Date paidDate receipted form sighted by assessmentmanagerName of officerwho sighted the form

Page 12DA Form 1 - DevelopmentApplicationdetailsVersion 1.1- 22 JUNE 2018

DA Form 2 - Building work detailsApprovedform (version 1.1 effective 22 JUNE 2018) made under Section 282 of the PlanningAct 2016.This form must be used to make a developmentapplication involving building work.For a development application involving building work only, use this form (DA Form 2) only. The DA Forms Guideprovidesadvice about how to complete this form.

For a developmentapplication involving building work associated and any other type of assessabledevelopment,use DA Form 1 - Developmentapplicationdetails and parts 4 to

6 of this form (DA Form 2).

Unless stated otherwise, all parts of this form must be completed in full and all requiredsupporting informationmustaccompanythe development application.One or more additional pages may be attachedas a schedule to this developmentapplication if there is insufficientspace on the form to includeall the necessary information.

This form and any other form relevant to the developmentapplication must be used to make a developmentapplication relating to strategic port land and Brisbanecore port land under the Transport/n/rastructureAct 1994,and airport land under the Airport Assets (Restructuringand Disposal)Act 2008. For the purposeof assessingadevelopmentapplication relating to strategicport land and Brisbane core port land, any reference to a planningscheme is taken to mean a land use plan for the strategic port land, Brisbaneport land use plan for Brisbanecoreport land, or a land use plan for airport land.

Note: All terms used in this form have the meaning given underthe Planning Act 2016, the Planning Regulation2017, or the DevelopmentAssessment Rules (DA Rules).

PART 1 - APPLICANT DETAILS

Applicant name(s)(individualorcompanyfuuneme) B/¼Q q CT N(b) DLLa\) f? 1/Y6-Contact name (only appbcabreforcompanies)

Postal address (FC Box or stmet address) I 1 $(?-(¿% $Tu6-WSuburb k I L CA /State 61..P.--DPostcode C /SCountry NM? D2 AContact number (7 - (b 2. HOEmad address (non-mandatory) rÅu /n liMobi[e number (non-mandatory)Fax number (non-mandatory)

Applicant's reference number(s)(f appocat2/e/

PART 2 - LOCATION DETAILS2) Location of the premises (complete 2.1 and/or2 2 if applicable)Note: Provide details below and attach a site plan for any or all premisespar1 of the developmentapplication. For further information, see DA Forr

uide_BeteveoLuin2.1) Street address and Iot on plan

[] Street N thewaterbut

QueenslandGovernment

j Additonalpremisesare relevantto this developmënt application and the details of these premises have beenattached in a schedute to this developmentapphcation

3) Are there any existing easementsover the premises?Note Easowat uscs v:ny |nn:ïghav!0:tcans!and :w! me to oc :dæ!:!:M cricctlya:u! u:wä:c|ø Fct fan!«i ,1±ïm:av on ammon!smd i aney may äffn::: !!w tuan:>smi&vHxvnt sa :ne DA 4ms G·,:?

°Yes - M easement locations, types and d with this developmentapplication(-] No

PART 3 -- FURTHER DETAILS

4) is the application only for building work assessable against the building assessmentprovisions?Yes - proceed to 8) .-] No

) identify the assessment manager(s) who will be assessing this developmentapplication

. - . . .. - - .. --e .... . .- -.-e e. ? - - e e- - ee - ... . ?Yes - a copy of the decision notice is attached to this developmentapplicationThe local govemment is taken to have agreed to the superseded planning scheme request - relevant documentsattachedNo

I agree to receive an rnformation request if determined necessary for this development apphcatrondo not agree to accept an informatronrequest for this development apphcation

Note By not agreetng to eccept an information request I, the apphcBot.acknowledge? that th

°Yes - the yellow local govemment/pnvate certifier's copy of the receipted QLeave form is attached to thrsdevelopmentapplicationD No -1, the appIlcantwill provide evidence that the portable long service leave levy has been paid before theassessmentmanagerdecides the developmentapplication I acknowledge that the assessmentmanager may givea developrnentapprovalonly if I provideevidence that the portable long service leave levy has been paidO Not apphcableAmountpaid Date paid (dd/mm/yy) QLeave levy number (A, B or E) '

10) is this developmentappucation in response to a show cause notice or required as a result of an enforcementnotice?

°Yes - show cause or enforcementnotice is attachedD No

The proposed development is on a place entered n the Queensland Heritage Registeror in a local

° government's Local Heritage Register. See the guidance providedat www.des.old.qovau about therequirements in relation to the development of a Queensland heritage placeName of the heritageplace Place ID

PART 4 - REFERRAL DETAILS

O Yes -- the Referralchecklist forbuilding work is attached to this development applicationNo - proceed to Part

5

Yes - referrai response(s) received and listed below are attached to this development apphcationNoReferral requirement Referral agency Date referral response

identify and descnbe any changesmade to the proposed developmentappHcatuj/ l\/ ll\/LrContact name (apptwableforcompames)

Page 3DA Form 2 - DevelopmentApplication detailsVersion 1.1- 22 JUNE 2018

Postal ad dress (P o Box or street address) I ¶ M 7 $7-/Yr) L-&y Ñ(¼DSuburb ¿_ ¿n/V/ LL FState 3µpPostcode ¿¿_39 {oContactnumber f }.,LL JJ.%

I à|Email address (non-mandatory)

Mobile number(non-mandatory) , ðl...( 2 Sp ( j 3|Fax number (non-mendatorys

@ Tick if a butiderhas not yet been engaged to undertake the work and proceedto 16) Otherwise provide thefollowing informationName(s) (mdividual or companytuli name)Contactname(apphcabletorcompanies)

QBCC heence or owner- buildernumberPostal address (P.O Box or street address)Suburb

State

Postcode

Contact numberEmall address (non-mandatory)

Mobile number(non-mandatory)Fa× number (non-mandatory)

a) What type of approval is being sought?Development permit

_j Prehminary approval

b) What is the fevel of assessment?Code assessmentm pact assessment (requirespubhc notification)

c Nature of the proposed building work (trck all apphcable boxes)New building or structure [ Repairs, alterations or additionsChange of buddmg classification povolvmghw/ding work) T Swimmrng pool and/or pool fenceDemolitton [ ] Relocat on or removal

d) Provide a descnptionof the work below or in an attached schedule

e) Proposed constructionmaterialsDoubfe brick Steel [ Curtain glass

External walls Brick veneer Timber [ ] AJuminiumStone/concrete ] Fibre cement . Other

FrameTimber Stee! [ } Aluminium

j Other

Page 4DA Form 2 - DevelopmentApplication detailsVersion 1.1- 22 JUNE 2018

Floor O Concrete O Timber O OtherO Slate/concrete O Tiles E] Fibre cementRoof covenng O Aluminium O Steel O Other

f) Existing buildmg use/classification?(ifappheabte}

g) New budding use/classification?(ifeppucao/a)

h) Re?evant plans ..Note Relevant plans are reqwred to be submitted for all aspects of this developmentapplication For further[nformat[on, see DA Fntms GwdaRelevent otans

Relevant plans of the proposed works are attached to the development appHcat on

17) What is the monetary value of the proposed building work?

El Yeåprovindetaist ël[8 NoAmour . id Dstè d/ni eferëndéní mber

PART 6 - CHECKLISTAND APPLICANT DECLARATION

The relevantparts of Form 2 - Buildingworkdetails have been completed 2 YesThis developmentapplication includesa matenalchangeof use, reconfigunnga lot or 2 Yesoperational work and is accompamed by a completed Form 1 - Development O Not appkcableapplication detailsRelevantplans of the development are attached to this development applicationNote Relevant plans are reqwred to be submitted forall aspects of this developmentapphcation For fæther Å Yesinformation,see oA Forms Gwde Relevant plans

The portable long service leave levy for OLeave has been paid, or will be paid before a O Yesdevelopment permit is issued % Not apphcable

By mak ng this development apphcation, I declare that au nformation in this development application is true andcorrect

3 Where an email address is provided in Part 1 of this form, I consent to receive future electronic communicationsfrom the assessmentmanagerand any referral agency for the developmentapplicationwhere wntten information tsrequired or permitted pursuantto sections 11 and 12 of the Electron/c TransactionsAct 2001Note it is unlawfulto intentionallyprovide false.ormisleading information

Privacy -pPersonal information collected En this form wW be used by the assessment manager and/or chosenassessment manager, any referral agency and/or budding certifier (including any profess onal advisers which may beengaged by those entities) while processmg, assessing and deciding the development apphcation 1All information relat ng to this development appHcation may be available for inspectionand purchase, and/orpubhshed on the assessmentmanager'sand/or referral agency'swebsitePersonal informatronWW not be disclosedfor a purpose unrelated to the PlanningAct 2016, Planning Regulation 2017and the DA Rules except where? such disc(osure is n accordance with the provisionsabout pubhc access to documents conta ned m the P/ann/ag

Act 2016 and the Planning Regulation 2017, and the access rules made under the PlanningAct 2016 and PlanningRegulation 2017, or

Page 5DA Form 2 - DevelopmentApplication detailsVersion 1.1-22 JUNE 2018

? required by other (egislation (including the Right to informationAct 2009); or? otherwise required by law.This inforrnation may be stored in relevant databases. The information collected will be retained as required

by the

Public RecordsAct 2007

PART 7 -FOR COMPLETION BY THE ASSESSMENTMANAGER - FOR OFFICEUSE ONLY

Date received: Reference numbers:

Classification(s)of approvedbuilding work

Name QBCC Certification Licence OBCC insurance receiptnumber number

Prescnbedassessment managerName of chosen assessmentmanagerDate chosen assessment manager engaged

Contactnumberof chosen assessment managerRelevant licence number(s)of chosen assessmentmanager

Confirm proposedconstruction materials.

O Double brick O Steel O Curtain glassExternal walls O Bnck veneer O Timber O Aluminium

O Stone/concrete O Fibre cement O OtherO Timber O Steel O Aluminium

Frame O OtherFloor O Concrete O Timber O Other

O Slate/concrete O Tiles O Fibre cementRoof covering O Aluminium O Steel O Other

Existin b il e éläÈÍfíEalión? /e

NÁwtni c

Page 6DA Form 2 - Deveiopment

AppHcation detailsVersion1.1-22 JUNE 2018

Ronald Dunning .

1839 Mt Stanley Road

Linville 4306

05 May 2019 _

Somerset Regional Council

Po Box 117

Esk4312

To Whom it May Concern . .

As owner of Lot 43 RP 15314 I consent to the making of a developmentapplication underthe Planning Act 2016 by Barrie Dunning for the purpose of establishingan access easementon L43 RP 15314 to allow access to L44 and L45 on RP15314.

Yours sincerely

Ronald Dunning

Overview lot 43, 44, 45 RP 15314 Access Easement27 3 32"5 152°29'4"E 27 3 32 s 152'30

RP (5314 NPW756

//RP15 14

RP15314

RP15314

NPY 56

RP15314

314 527°4'26"S 152°29'4"E 27°4'26"S 152'30 5"E

A product ofQueensland Globe

250 metres

Print Date: 11/5/2019 © State of Queensland2019Paper Size: A4 You are responsible for ensuring

Imagery that the map is suitable for yourincludes material © CNES purposes.reproduced under licence The State of Queensland makesfrom AirbusDS, all rights no representation or warranties in

reServed, © 21AT © Earth-i, relation to the map contentsandall rights reserved,2019 disclaims all liability.

Lot 43 RP15314 Access mapi27 4 5"S 152 29'19'E 27 4'5'S 1,''m'40"E

27°4 24"S 152429'19"E 27"4'24"S 152'29'40"E

A product ofQueensland Globe

Print Date:11/5/2019.

© State of Queensland 2019Paper Size:A4 You are responsible forenSuring

Imagery that the map is suitable for yourincludes materiar © CNES Purposes,reproduced underlicence The State of Queenslandmakesfrom AirbusDS, all rights no representation or warranties in

reserVed,© 21AT © Earth-1, relation to the map contents andall rights reserved,2019 disclaims all liability.

Lot 43, 44 RP15314 map227^3'48"S 152 29'18'E 27' 3'48"S 132 :·9'39"!

27"4'7"S 152^29'18"E 27 4'7'S 152 29'39"E

A product ofQueensland Globe

100 metres

Print Date: 11/5/2019PaperSize: A4

Imageryincludes material © CNESreproducedunder licencefrom AirbusDS, a Il rights

reserved, © 21AT © Earth-i,all rights reserved,2019

© State of Queensland 2019You are responsible forensuringthat the map is suitable for your

purposes.The State of Queensland makesno re presentation or warranties inrelation to the map contentsand

disclaims all liability.

Lot 43, 44, 45 RP15314 maps27"3 32'S 152*29'18"E 2 3 3ys 15 0

27°3'51"S 152°29'18"E

A product ofGo¤eemsià,datobe

27"3'51'S 152"29'39'E

N

100 metres

Print Date:11/5/2019 © State of Queensiand 2019Paper Size: A4 You are responsible for ensuring

Imagery that the map is suitable for yourincludes material © CNES purposes.reproduced under licence The State of Queensland makesfrom AirbusDS, a Il rights no re Pre se ntation or warranties in

resemed,© 21AT © Earth-i, relation to the map contentsandall rights reserved,2019 disclaims all liability.

SomersetREGIONAL COUNCIL

RECEIVEDSomerset RegionalCouncil OFFICIAL RECEIPT

80010304A E JgDRENNNG 2 8 MAY 2019 27-os-201e

KILCOYQLD 4515Doc ID:

Box No: R

Details Amount

Received from: BARRIE J DUNNING 1,317.00

-For: Planning & DevelopmentFees Total includesGST 0.00 -Drawers:

System Code Details GST AmountGen Ledger 8120-1000-0001 DevelopmentApplications 0.00 1,317.00

Totals 0.00 1,317.00

Cash Tendered Change Cheques Direct Dep Credit Card EFTPOS Rounding

0.00 0.00 0.00 0.00 0.00 0.00 1,317.00 0.00

Our Ref: CASSANDRAW

ABN 50 138 958249CouncilChambers - 2 Redbank Street, Esk QLD 4312

Address all correspondenceto - Chief Executive Officer, SomersetRegional Council,PO Box 117, Esk QLD 4312P 0754244000 F 0754244099 E mail@somerset.qld.gov.au W www.somerset.qld.gov.au